经伤椎置钉与跨伤椎椎弓根螺钉内固定治疗胸腰椎爆裂骨折疗效比较

目的回顾性分析比较经伤椎置钉与跨伤椎椎弓根螺钉内固定治疗胸腰椎爆裂骨折的临床疗效。方法本组91例胸腰椎爆裂型骨折患者，其中经伤椎置钉患者43例，跨伤椎置钉患者48例，本组均采用后入路经椎弓根置螺钉内固定术，分别在术前、术后2周、术后3个月、术后6个月进行疼痛视觉模拟评分（VAS）、椎体高度压缩率及伤椎Cobb’s角测量分析，两组进行对比。结果本组随访6～24个月。术前、术后2周两组之间的VAS评分、椎体高度压缩率及伤椎Cobb’s角比较，差异无显著统计学意义（P〉0．05）。术后3个月、术后6个月两组之间的VAS评分、椎体高度压缩率及伤椎Cobb’s角比较，差异有显著统计学意义（P〈0．01）。结论经伤椎置钉椎弓根螺钉内固定术是治疗胸腰椎爆裂型骨折比较安全有效的方法，可以增强内固定系统的牢固性，减少术后并发症，远期疗效肯定。

The efficacy of posterior pedicle screw fixation via the broken vertebra versus that of the procedure beyond the broken vertebra for thoracolumbar burst fractures

Objective To analyze the efficacy of fixation with screws via the broken vertebra versus that of the procedure beyond the broken vertebra for thoracolumbar burst fractures. Methods 91 patients with thoracolumbar burst fractures underwent posterior pedicle screw fixation （ PPSF ） via （ 43 patients ） or beyond （ 48 patients ） the broken vertebra. Pain visual analogue scale （ VAS ） scores, vertebral compression ratio and Cobb＇s angle were used to evaluate the changes before the procedure and at week 2 and months 3 and 6. Results All the patients were followed-up for 6 to 24 months. There were no signi？cant differences in VAS scores, vertebral compression ratio and Cobb＇s angle between the two groups before surgery and at week 2 （ P〉 0.05 ）. The VAS scores, vertebral compression ratio, and Cohb＇s angle differed significantly between the two group at months 3 and 6 （ P〈 0.01 ）. Conclusions Posterior pedicle screw fixation via the broken vertibra is safer and more effective. It can secure the stability of internal fixation and reduce the postoperative complications, and has a long-term efficacy.